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my Blue Access WV EPO Silver 4450 HSA
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my Blue Access WV EPO Silver 4450 HSA

Overview
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my Blue Access WV EPO Silver 4450 HSA is an individual health health plan issued by Highmark Blue Cross Blue Shield West Virginia and is available for the year 2019. This health plan is offered by the federal government through HealthCare.gov and the Affordable Care Act (ACA).

Where Do I Need to Live to Quality for this Plan?

This plan is available for qualifying individuals who live in Morgan county, West Virginia.

What Type of Health Plan Is This?

This plan is an EPO plan, which is also known as an "Exclusive Provider Organization." An EPO is a managed care plan where services are covered so long as the the hospitals, dentists, and other health providers in the plan's network are used.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
Highmark Blue Cross Blue Shield West Virginia
Plan ID
31274WV0510001
Coverage area
Morgan County, West Virginia
Phone
Local Phone: 1-888-601-2109
Toll-Free: 1-888-601-2109
TTY: 1-888-601-2109
Plan type
EPO
Coverage type
Medical deductible
$4,450
Out-of-pocket maximum
$6,650
Generic drug co-pay
10% Coinsurance after deductible
Preferred brand drug co-pay
10% Coinsurance after deductible
Primary care physician visit cost
10% Coinsurance after deductible
Specialist doctor visit cost
10% Coinsurance after deductible
Doctor Visits
Primary Care Visit 10% Coinsurance after deductible
Specialist Visit 10% Coinsurance after deductible
Emergency Room Visit 10% Coinsurance after deductible
Inpatient Facility Visit 10% Coinsurance after deductible
Inpatient Physician Visit 10% Coinsurance after deductible
Prescription Drugs
Generic Drugs 10% Coinsurance after deductible
Preferred Brand Drugs 10% Coinsurance after deductible
Non-preferred Brand Drugs 10% Coinsurance after deductible
Specialty Drugs 10% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $4,450
Medical Maximum Out Of Pocket (Individual) $6,650
Medical Deductible (Family) $8,900
Medical Maximum Out Of Pocket (Family) $13,300
Drug Deductible
Drug Deductible (Individual) Included in Medical
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) Included in Medical
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 349
Premium Child Age 18 417
Premium Adult Individual Age 21 457
Premium Adult Individual Age 27 479
Premium Adult Individual Age 30 519
Premium Adult Individual Age 40 584
Premium Adult Individual Age 50 816
Premium Adult Individual Age 60 1,241
Premium Couple 21 914
Premium Couple 30 1,038
Premium Couple 40 1,169
Premium Couple 50 1,633
Premium Couple 60 2,482
Couple+1 child, Age 21 1,264
Couple+1 child, Age 30 1,388
Couple+1 child, Age 40 1,519
Couple+1 child, Age 50 1,983
Couple+2 children, Age 21 1,614
Couple+2 children, Age 30 1,738
Couple+2 children, Age 40 1,868
Couple+2 children, Age 50 2,333
Couple+3 or more Children, Age 21 1,964
Couple+3 or more Children, Age 30 2,088
Couple+3 or more Children, Age 40 2,218
Couple+3 or more Children, Age 50 2,683
Individual+1 child, Age 21 807
Individual+1 child, Age 30 869
Individual+1 child, Age 40 934
Individual+1 child, Age 50 1,166
Individual+2 children, Age 21 1,157
Individual+2 children, Age 30 1,218
Individual+2 children, Age 40 1,284
Individual+2 children, Age 50 1,516
Individual+3 or more children, Age 21 1,507
Individual+3 or more children, Age 30 1,568
Individual+3 or more children, Age 40 1,634
Individual+3 or more children, Age 50 1,866
Reference
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  • HealthCare.gov. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov
  • The 'metal' categories: Bronze, Silver, Gold & Platinum. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plans-categories
  • Health insurance plan & network types: HMOs, PPOs, and more. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plan-types